Dissociative Disorders

Dissociative disorders (DD) are characterized by involuntary disruption or discontinuity in the normal integration of one or more of the following: identity, sensations, perceptions, affects, thoughts, memories, and control over bodily movements. To meet diagnostic criteria, dissociative symptoms must be sufficiently severe to result in significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. More recently, there has been a rise in the number of reported cases of dissociation, which may be attributed to greater awareness of the diagnosis among mental health professionals. The most commonly diagnosed DD in Western countries is the Other Specified Dissociative Disorder category. While in developing countries, dissociative trance and “possession trance” syndromes make up the bulk of the cases of DD. One of the important developments in the modern understanding of DDs is the establishment of a clearer link between trauma and dissociation. New in the ICD-11, which is the addition of dissociative neurological symptom disorder (DNSD), formerly known as Conversion Disorder, is characterized by the presentation of motor, sensory, or cognitive symptoms that imply an involuntary discontinuity in the normal integration of motor, sensory, or cognitive functions and are not consistent with a recognized disease of the nervous system, other mental or behavioral disorder, or other medical conditions. This chapter discusses the diagnostic criteria and treatment of each diagnosis contained within this category.